Healthcare Provider Details
I. General information
NPI: 1801618756
Provider Name (Legal Business Name): LAUREN E. BIESTEK, DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2114 W ALGONQUIN RD
LAKE IN THE HILLS IL
60156-1370
US
IV. Provider business mailing address
4869 ARGYLE LN
MCHENRY IL
60050-6606
US
V. Phone/Fax
- Phone: 847-305-3122
- Fax:
- Phone: 847-305-3122
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAUREN
ELIZABETH
BIESTEK
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 847-204-0959